Individual provider Active NPI

Kashina Annette Simms, LCSW

  • Clinical Social Worker
  • Chesapeake, VA
National Provider Identifier
1730418872
Registry record updated Jun 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904007282 Issued in VA
Practice address
1015 Eden Way N Ste B
Chesapeake, VA 23320-2787
Phone
(757) 609-2726
NPI assigned
Dec 21, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1041C0700X 109509 TX
Clinical Social Worker 1041C0700X 0904007282 VA Primary

Addresses

Primary practice location

1015 Eden Way N Ste B
Chesapeake, VA 23320-2787

Mailing address

732 Eden Way N Ste E-507
Chesapeake, VA 23320-2798
Phone (757) 676-2607

Other practice location 1

1418 Gomer Ln
Harker Heights, TX 76548-6003
Phone (757) 609-2726

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20101028000812 VA Practitioner - Clinical Social Worker 9638363120 Reassigns benefits to 1 organization
I20230808001254 TX Practitioner - Clinical Social Worker 9638363120 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2001
Medicare assignment
May accept Medicare assignment
Group practices
Empowerment Counseling Center LLCGroup PAC ID 1557631652, 5 clinicians

Practice addresses (Care Compare)

1015 Eden Way N
Suite B
Chesapeake, VA 23320-2787
Phone (757) 609-2726

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
109509TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Empowerment Counseling Center LLC Clinical CurrentSince May 10, 2017 Accepting new patients

Locations

1015 Eden Way N
Ste B
Chesapeake, VA 23320
Phone (757) 609-2726

732 Eden Way N
Ste E507
Chesapeake, VA 23320
Phone (757) 412-7840

413 Mount Cross Rd
Ste 106
Danville, VA 24540
Phone (252) 258-4783

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1261353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1730418872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "732 EDEN WAY N STE E-507",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233202798",
            "telephone_number": "757-676-2607",
            "fax_number": "757-609-2874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 EDEN WAY N STE B",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233202787",
            "telephone_number": "757-609-2726"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1418 Gomer Ln",
            "address_purpose": "LOCATION",
            "city": "Harker Heights",
            "state": "TX",
            "postal_code": "765486003",
            "country_code": "US",
            "telephone_number": "757-609-2726",
            "fax_number": "757-609-2874",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMMS",
        "first_name": "KASHINA",
        "middle_name": "ANNETTE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-12-21",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "109509",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904007282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesapeake, VA

Sources for this page

Verify at the official NPI Registry.